Provider Demographics
NPI:1154085249
Name:RIDGE & SWALE COUNSELING LLC
Entity Type:Organization
Organization Name:RIDGE & SWALE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC, CAADC
Authorized Official - Phone:269-599-2250
Mailing Address - Street 1:1046 S SOUTH LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:INTERLOCHEN
Mailing Address - State:MI
Mailing Address - Zip Code:49643-9714
Mailing Address - Country:US
Mailing Address - Phone:269-599-2250
Mailing Address - Fax:
Practice Address - Street 1:1200 W 11TH ST STE 214
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3289
Practice Address - Country:US
Practice Address - Phone:269-599-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty